抑郁焦虑共病及抑郁症病人抉择加工策略研究

DECISION-MAKING PROCESS IN PATIENTS WITH COMORBID ANXIETY AND DEPRESSION AND THOSE WITH SIMPLE DEPRESSION

目的探讨抑郁焦虑共病病人及抑郁症病人抉择加工策略的异同。方法依据中国精神疾病诊断与分类标准第3版（CCMD-3）选取抑郁焦虑共病病人、抑郁症病人和正常对照者各30例。应用E-prime程序编制3种类型（风险、含糊和确定）的抉择任务，所有被试均完成上述抉择任务，记录反应时、正确率和风险偏好。结果在3种类型抉择条件下，3组间反应时比较，差异均有统计学意义（F=27．968～43．557，P〈0．01）；任一抉择类型下，共病组和抑郁组与对照组比较，反应时均显著延长（t=6．758～8．918，P〈0．01）；而各组内3种不同抉择类型之间反应时比较，仅对照组风险抉择反应时显著长于含糊抉择反应时（F=3．671，t=2．693，P〈0．01）。在同一类型抉择条件下，3组间正确率比较，差异均无统计学意义（P〉0．05）；而各组内3种不同抉择类型之间正确率比较，差异均有统计学意义（F=14．237～28．039，P〈0．01），3组在风险和含糊抉择类型下的正确率均低于确定抉择类型下的正确率（t=4．269～6．269，P〈0．01）。在风险、含糊抉择类型下，3组间风险偏好比较，差异均无统计学意义（P〉0．05）；而各组内风险偏好比较，仅共病组在风险抉择时的风险偏好显著低于含糊抉择时的风险偏好（t=1．916，P〈0．05）。结论抑郁焦虑共病和抑郁症病人抉择反应时较正常人延长；共病病人在含糊抉择类型下更倾向于冒险。

Objective To explore the similarities and differences of decision-making process among patients with comorbid anxiety and depression（CAD）and those with simple depression. Methods According to the third edition of the Classification and Diagnostic Criteria of Mental Disorders（CCMD-3）of China,30 patients with CAD,30 with depression and 30 normal controls were enrolled.Three different kinds of decision tasks（risk,ambiguity and certain）were programmed with E-prime.All the subjects completed the above items,the reaction time,accuracy rate and risk favor were recorded. Results There were significant differences in reaction time among the three groups under the three selective conditions（F=27.968-43.557,P〈0.01）.CAD group and simple depression group had longer reaction time than the the control group under anyone of the three slections（t=6.758-8.918,P〈0.01）.In each group,the reaction time between the three selections only in the control group the reaction time of risk selection was notably longer than ambiguity selection（F=3.671,t=2.693,P〈0.01）.Under the same selective condition,the difference among the three groups was not significant in terms of accuracy rate（P〉0.05）,and the differences among the three selective conditions in each group were significant with regard to accuracy rate（F=14.237-28.039,P〈0.01）.The accuracy rates of risk and ambiguity choice were lower than certain choice in the three groups（t=4.269-6.269,P〈0.01）.There were no significant differences with regard to risk favor among the three groups under risk and ambiguity selection（P〉0.05）.A comparison in each group with regard to risk favor,only in the CAD group showed much longer than ambiguity selection（t=1.916,P〉0.05）. Conclusion The reaction time of CAD patients and depression patients is longer than normal people.The patients of CAD group have more tendency of risk under ambiguity choice.